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Chronic obstructive pulmonary disease (COPD) is an irreversible lung disease characterized by chronic obstruction of lung airflow that interferes with normal breathing.1 It affects roughly 14% of the male and 7% of the female population globally,2 and it is the third-leading cause of death in the United States.3 The cost of COPD in the United States was projected to be $50 billion in 2010.4 Among patients with COPD in the United States, approximately 800,000 receive long-term oxygen therapy (LTOT).5 Long-term oxygen therapy has been widely accepted as a means to lower the mortality rate in patients with COPD, particularly in patients with severe hypoxemia.6 However, the mortality benefit of this therapy in patients with COPD with mild to moderate hypoxemia is unclear, with limited evidence for its use in the literature.7,8

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